Experiences of African American Mothers Following the Death of Their Infants

ObjectiveTo explore the lived experiences of African American mothers after the death of their infants.DesignQualitative, interpretive phenomenologic study.SettingNortheast Louisiana.ParticipantsSeven self-identified African American women whose infants died during the first year of life; the women’s ages ranged from 18 to 38 years at the time of the infant’s death.MethodsHeidegger’s interpretive phenomenologic approach guided the data collection and analysis. The women were interviewed using in-depth questioning to determine the meaning of the infant loss experience and their subsequent efforts to cope.ResultsSix themes represented the experiences of loss for the mothers: Shattered Dreams, Questioning God, Dissociation, Paralyzing Fear, Left in the Dark, and Uniqueness of Grieving. Three themes affected the women’s efforts to cope after their loss: Authentic Presence, Spiritual Empowerment, and Disconnectedness.ConclusionAfrican American women who experienced infant death described intense feelings of loss, guilt, and isolation. These negative emotions can potentially affect their physical and psychological health. These findings may help health care providers develop culturally sensitive understanding of African American mothers’ experiences of loss and equip providers to provide holistic assessment, appropriate support, and treatment for these vulnerable women.     

The Astounding Breadth of Health Disparity: Phenome-Wide Effects of Race on Disease Risk

ObjectiveWe conducted a phenotype-wide association study (PheWAS) to compare diagnoses among Blacks with those of Whites in one health center in Tennessee using data from 1,883,369 patients.MethodsWe used our deidentified EHR, the Synthetic Derivative, to assess risk of diagnoses associated with Black as compared with White race using Firth logistic regression with covariates including age, sex, and density of clinical encounters.ResultsThere were anchoring associations in both directions, including the highest increased risk for Blacks of having sickle cell anemia, and strongest decreased risk of basal cell carcinoma. Results included established areas of disparity and many novel associations.ConclusionsPheWAS is a viable tool for calculating risk associated with any biomarker. The current analysis provide a new approach to generating hypotheses and understanding the breadth of health disparities. Future analyses will further explore causality, risk factors, and potential confounders not accounted for here.     

Video gaming and gender differences in digital and printed reading performance among 15-year-olds students in 26 countries

Video games are a favorite leisure-time activity among teenagers worldwide. This study examines cross-national gender differences in reading achievement and video gaming and whether video gaming explains gender differences in reading achievement and differences in performance between paper-based and computer-based reading. We use data from a representative sample of 145,953 students from 26 countries who sat the PISA 2012 assessments and provided self-reports on use of video games. Although boys tend to have poorer results in both the computer-based and the paper-based reading assessments, boys' under achievement is smaller when the assessment is delivered on computer than when it is delivered on paper. Boys underperformance compared to girls in the two reading assessments is particularly pronounced among low-achieving students. Among both boys and girls moderate use of single-player games is associated with a performance advantage. However, frequent engagement with collaborative online games is generally associated with a steep reduction in achievement, particularly in the paper-based test and particularly among low-achieving students. Excessive gaming may hinder academic achievement, but moderate gaming can promote positive student outcomes. In many countries video gaming explains the difference in the gender gap in reading between the paper-based and the computer-based assessments.     

Changes and mediators of survival disparity among Black liver transplant recipients in the United States

A landmark 2002 study identified Black liver transplant (LT) recipients as having lower post-LT survival compared to other races. While persistent disparities exist, changes over time and mediating factors are understudied. Capturing LT recipients between 2002 and 2018 in UNOS, we used logistic regression and Cox proportional-hazard models to calculate differences in post-LT mortality among races. We examined interactions between transplant year and race. A mediation analysis assessed biologic and environmental factors potentially associated with race differences in post-LT survival. The cohort included 46,997 LT recipients (3898 Black;36,560 White;6539 Hispanic). In most years, Black (vs. White) LT recipients had a higher probability of age-adjusted mortality, not observed among Hispanics. In multivariable analysis, Blacks (vs. Whites) had higher (aHR = 1.15, 95% CI 1.07–1.24), whereas Hispanics had lower (aHR = 0.78, 95% CI 0.72–0.83) risk of mortality. Differences in post-LT mortality among Blacks (vs. Whites) narrowed between 2002 and 2009, were similar between 2010 and 2013, and may have worsened between 2014 and 2018. Race differences were larger for mortality beyond 1-year post-LT (vs. within 1-year), and among non-HCV (vs. HCV). Alcohol-associated liver disease (ALD) was the strongest mediator (13.9%, 95% CI 8.7–32.7%) of the Black–White disparity in 2010–2018. Our analyses suggest disparities may worsen with longer follow-up, as HCV recedes with elimination efforts, and with further increases in ALD.